( document Mediated Delivery )

The DocMD project ended in 2005

Project Description

  1. Introduction
  2. Background
  3. Prospero
  4. Identification of Need
  5. Methodology and Approach
  6. Project Goal, Objectives, and Outcomes
  7. Timeline
  8. Project Hospitals List
  9. Participant Libraries Resources (Implementor 's Guide, Surveys, Marketing Tools)
  10. Project FAQ (also in PDF)
  11. Project Reports

1. Introduction

    The John A. Prior Health Sciences Library at The Ohio State University has partnered with the Cleveland Health Sciences Library at Case Western Reserve University in the a project that helps to establish direct-to-patron document delivery services for hospital libraries.  This project is being funded entirely through an $85,000 subcontract with the National Network of Libraries of Medicine, Greater Midwest Region.  

   This pilot project utilizes a centralized processing center to provide hospital libraries with the ability to deliver documents to their patrons electronically without having to install and maintain a local electronic document delivery system.  The goal of this investigation is the development of a model for use by other resource libraries in other regions of the country. 

      During the eighteen-month project timeline a centralized service center will be established at the Prior Library.   A library outreach and educational service will be established at the Prior Library and Cleveland Library to support participants.  Tools for communications, gathering statistics, and user satisfaction will also be created. The service will be rolled out in 2 phases to the libraries listed in this proposal.   

2. Background 

    The impact of literature searching on the reduction of the length of stay, lowering patient care costs, and positively affecting patient care has been well documented. [1, 2, 3 ] Identifying relevant materials in the literature through the use of bibliographic search tools such as PubMed, however, is only half of the process.  Health care professionals also need to obtain copies of the original articles.  Traditionally, the professional visits the hospital library and either reads or makes a copy of the article(s) needed.  Those articles that are not a part of the library’s collection are obtained by the library through the process of interlibrary loan.   

    Most medical libraries offering interlibrary loan services utilize the National Library of Medicine’s DOCLINE® system.  A request for a specific article is submitted to DOCLINE® , which routes the request electronically to other libraries until one fulfills the request.  The article is traditionally delivered to the requesting library using mail or FAX services.  A 1986 study revealed a turnaround time between libraries of 13.76 days. [4]

    The advent of the Internet brought new delivery systems which utilized the technology, such as Ariel, which allows libraries to send articles to the requesting libraries in electronic format using the Internet. [5] In one study Ariel® reduced the mean turnaround time between libraries to 2.52 days. [6] Ariel ® provides higher resolution copies than a fax machine and is a cost-effective alternative to using traditional fax and mail distribution systems. Both the sending and receiving libraries must have the Ariel ® software installed. [7]

    Libraries that use Ariel ® generally print the articles they received electronically for distribution to the patron, often by mail.  This manual processing of documents for delivery can add several days to the overall turnaround time.  Ariel ® does allow libraries to utilize email to deliver documents electronically.  However, there are problems redistributing native Ariel® documents using this feature.

3. Prospero

     To take advantage of the ability of the Web to provide immediate “anywhere, anytime” access to documents, the Prior Library created a software program Prospero. [8] Prospero is a Web-based document delivery system designed as a complement to the Ariel ® software system.  Prospero converts Ariel ® files, or any TIFF formatted images, into Web accessible Adobe Acrobat® formatted documents (PDFTM) and places them on a Web server.  Library patrons may choose to access and download their documents using any Internet connection with Web access.  Figure A details the Prospero work-flow process.

     Prospero was the recipient of the year 2000 Frank Bradway Rogers Information Advancement Award presented by the Medical Library Association.  The project has also been mentioned in several publications on the topic of open source software for libraries. [9, 10, 11] Prospero is being distributed by the Prior Library under an open source license that allows any library to use it free of charge.  The DocMD project will utilize Prospero to redistribute articles to health care professionals.


Figure A: Prospero Work Flow

4. Identification of Need

   Prospero provided opportunities for the principal investigator to present papers about the project at various professional conferences.  This provided opportunities to interview many librarians. Through these discussions and subsequent email correspondence it became very apparent that many hospitals had difficulty implementing any electronic document delivery service. 

   Several explanations as to why hospital libraries have not implemented electronic document delivery services have been identified.  [12]

  •     Many hospital libraries have very small staffs; some are staffed by a solo professional.  These libraries frequently do not have the human resources needed to provide a full complement of traditional library services, let alone computer enhanced ones.

  •    Hospital libraries often rely on their hospital’s computing staff for any and all technical support.  Many hospital librarians commented that their hospital’s computing staff is not responsive to the unique needs of the library. 

  •     “Firewall” issues are a major impediment to hospital implementation. [13] To secure Intranet sites, hospitals often filter all Internet traffic to allow only specific Internet traffic into their hospital networks, including “Internet communications ports” utilized by Ariel ® and similar systems.  Many librarians do not have the authority or can identify the proper channels to unblock these ports.  Even when the proper contacts are made, bureaucratic obstacles frequently slow and often prevent the ports from being opened for library use.  

   The DocMD project jumps these obstacles. No additional staff are needed at project libraries. All systems are located and maintained at the central site. Since the DocMD system utilizes common Internet communication ports it does not present any security issues for hospitals and can communicate through hospital firewalls.

   In December 2000, phone calls were made to several DOCLINE ® hospital libraries in the central Ohio region to determine interest and need to provide electronic document delivery service.  After an explanation of the proposed project every librarian contacted expressed interest in participation with great enthusiasm.  These additional interviews also reinforced the issues already identified.  In early 2001, the concept for the project was also introduced at a meeting of the Medical Library Association of Northern Ohio.  It was also well received by the attendees.  In June 2001 a general call for participation was announced to all libraries in both regions via email.  A temporary Web site was established which outlined the goals of the project and the expectations of project participants.

To participate, hospitals libraries need to:

  • Be DOCLINE® participants
  • Identify the medical and professional population sizes at their institution this project could potentially reach
  • Provide a letter indicating interest in participating in the project.
  • Be willing to assist their users with local computing/Internet access issues
  • Implement and market the service to their patrons
  • Be willing to "go with the flow." As with any pilot project there will be implementation issues.
  • Provide the project team with feedback and participate in the evaluation process    

5. Methodology and Approach

   Instead of a document being mailed or faxed to the borrowing library, any requests that can be fulfilled and delivered using Ariel®  are sent to the DocMD central mediated delivery site.  These documents are then redistributed by the central site directly to the patron in electronic format via the Web.  The DocMD delivery model is outlined in Figure B.  This allows patron with Internet access to download their documents using any class of computer, desktop or portable, and with any Web browser.  The only additional software needed by the patron is Adobe Acrobat, which is available free of charge.


Figure B:  DocMD Delivery Model

   With this model, each hospital library will modify their DOCLINE ® DOCUSER record by adding the address of the DocMD central Prospero server in the Ariel ® field. Each library then requests items using DOCLINE ® as they did before.  The address of the central Prospero server is automatically printed on the DOCLINE ® request.  The lending libraries send the documents to the central DocMD/Prospero server. 

   The lending libraries need not be a project participant; they just have to be willing and able to send documents electronically.  They don’t even need to know the DocMD project exists. (NOTE:  When the hospital library requests Ariel ® delivery on DOCLINE ®, it only routes to Ariel ®  libraries. Requests that must route to other hospitals in order to receive free copies may have to be routed separately from the project requests as “mail” requests.)

   Staff at the DocMD central site processes the documents.  The server automatically emails the patron alerting them that a document is available.  The hospital librarian has no involvement in this step, beyond receiving notification that the transaction has occurred.  Finally, the patron accesses the server and downloads the document (or the librarian could do it if patron does not have computer with Web access).  If a document cannot be delivered to the patron using this system due to a server failure or any other reason, the Mediated Delivery Center will reroute those documents to the library or direct to patron via FAX or another means as requested by the library or patron.

     Each participant library will decide how DocMD will be implemented at their institution.  The librarians at these locations know their patron needs and are best positioned to determine which mix of delivery options works in their environment.  They will also responsible to market and promote the service to their patrons.  DocMD participants will continue to order documents using DOCLINE ®.  Since each library manages their DOCLINE ® profile, it is up to each to determine how that profile will be modified to take advantage of this service.

References

  1. Klein, Michele S, at el. "Effect of Online Literature Searching on Length of Stay and Patient Care Costs" Academic Medicine. June 1994, 69(6):489-495.
  2. Marshall, Joanne G. "The Impact of the Hospital Library on Clinical Decision Making: The Rochester Study" Bulletin of the Medical Library Association. April 1992, 80(2):169-178.
  3. King, David N. "The Contribution of Hospital Library Information Service to Clinical Care: A Study in Eight Hospitals." Bulletin of the Medical Library Association. October 1987, 75(4):291-301
  4. Budd, John, "Interlibrary Loan Service: A Study of Turnaround Time" Reference Quarterly, Fall 1986: 75-80.
  5. Jackson, Mary E., "Using Ariel, RLG's Document Transmission System to Improve Document Delivery in the United States," Interlending & Document Supply 20, no. 2 (1992): 49-52.
  6. Sellen, Mary, "Turnaround Time and Journal Delivery: A Study of Four Systems" Journal of Interlibrary Loan, Document Delivery, and Information Supply. 1999, 9(4):65-72
  7. Landes, Sonja, "The Ariel Document Delivery System: A Cost-Effective Alternative to the Fax," Journal of Interlibrary Loan, Document Delivery & Information Supply 7, no. 3 (1997): 61-72.
  8. Schnell, Eric H. "Freeing Ariel: The Prospero Document Delivery Project", Journal of Interlibrary Loan, Document Delivery, and Information Supply, 1999 10(2):89-100.
  9. Chudnov, Daniel. "Open Source Software: The Future of Library Systems?" Library
    Journal. August 1999:40-43.
  10. Kiernan, Vincent. "The Open Source Movement Turns Its Eye to Science", Chronicle of Higher Education. November 5, 1999:A51.
  11. Mickey, Bill. "Open Source and Libraries: An Interview with Dan Chudnov", Online, 2001
    25(1):
  12. Dee, Cheryl R and Wellik Kay E. "Current Environment of Hospital Library Reference: Part 1 - Transition to Technology", Medical Reference Services Quarterly. Winter 2000, 19(4):89-98.
  13. McKnight, Michelynn. "Ariel and Hospital Firewalls: The Struggle for Inetrnet Document Delivery", Journal of Hospital Librarianship. 2001. 1(4):1-17.


docMD is funded through support by the National Network of Libraries of Medicine,
Greater Midwest Region. Ohio State University Project Number 743202

URL: http://docmd.med.ohio-state.edu/

Last updated by EHS on 9/23/2003